Industry Support of CME — Are We at the Tipping Point?

Michael A. Steinman, M.D., C. Seth Landefeld, M.D., and Robert B. Baron, M.D.

N Engl J Med 2012 366:1069-1071 (March 22, 2012)

Public scrutiny and the threat of government regulation are leading to a decline in industry-sponsored funding of accredited continuing medical education (CME) for physicians. This decline represents an opportunity to make CME more relevant, cost-effective and less open to bias.

How Safe is Your Neighborhood? Perceived Neighborhood Safety and Functional Decline in Older Adults

Vivien K. Sun, Irena Stijacic Cenzer, Helen Kao, Cyrus Ahalt and Brie A. Williams

Journal of General Internal Medicine 2011 (December 9, 2011)
DOI: 10.1007/s11606-011-1943-y

Because little is known about the relationship between perceptions of neighborhood safety and long-term functional decline in older adults, the goals of this study were to determine: (1) the baseline relationship between perceived neighborhood safety, health and function in older adults, and (2) the association between perceived neighborhood safety and 10-year functional decline in a nationally representative sample of Americans aged 50 years or older.

Discussing Overall Prognosis with the Very Elderly

Alexander K. Smith, M.D., M.P.H., Brie A. Williams, M.D., and Bernard Lo, M.D.

N Engl J Med 2011 365:2149-2151 (December 8, 2011)

It’s late in the day in the office of a busy primary care physician, who is relieved to see that his last patient is a woman who, though 86 years old, has multiple stable medical problems and is visiting for her annual exam. The patient is accompanied by her daughter, who helps her mother with several activities of daily living, including bathing, dressing, and balancing her checkbook. During the visit, the daughter asks about preventive health measures for her mother: “It’s been years since her last colonoscopy, hasn’t it?”

Predicting Alzheimer’s risk: why and how?

Deborah E Barnes and Sei J Lee

Alzheimer’s Research & Therapy 2011 3:33 (November 25, 2011)
DOI:10.1186/alzrt95

Because the pathologic processes that underlie Alzheimer’s disease (AD) appear to start 10 to 20 years before symptoms develop, there is currently intense interest in developing techniques to accurately predict which individuals are most likely to become symptomatic.

Training Clinicians
Building a System for an Aging Century

Anna Chang, MD; Elizabeth Chur; Helen Kao, MD; Suzanne Kawahara, MBA; Brie Williams, MD

San Francisco Medicine 2011 84(9):15-16 (November 2011)

There are not enough health care professionals trained to care for older adults with complex conditions. While there is an estimated need for 20,000 geriatricians to effectively care for our burgeoning population of older adults, there are about 7,100 board-certified geriatricians in the United States today.

Improving Primary Care for Older Patients: Challenge for the Aging Century
Comment on “Practice Redesign to Improve Care for Falls and Urinary Incontinence”

Helen Kao, MD; C. Seth Landefeld, MD

Arch Intern Med. 2010 170(19):1772-1773 (October 25, 2010)
DOI:10.1001/archinternmed.2010.389

We have entered the aging century. The global population older than 65 years will double by 2040, with the most rapid increase among people older than 80 years.¹ The aging of populations will challenge health care systems around the world: not only will greater numbers of people have chronic diseases, such as heart failure or cancer, but also many will develop disabling geriatric conditions, such as dementia, difficulty walking, falling, or incontinence. Geriatric conditions are underdiagnosed, and their treatment requires expertise beyond a prescription or surgery. These complex conditions diminish the length and quality of life and the ability of individuals to engage in society.²

Recognizing Dementia as a Terminal Illness in Nursing Home Residents

Anna Chang, MD and Louise C. Walter, MD

Arch Intern Med. 2010 170(13):1107-1109 (July 12, 2010) DOI:10.1001/archinternmed.2010.166

The number of persons with dementia is expected to triple to 13.2 million over the next 40 years, and many will die in nursing homes.¹ Up to 90% of those with advanced dementia require nursing home level of care at some point in their lives, and 67% of dementia-related deaths in the United States occur in nursing homes today.^2,3 Yet, many nursing home residents with advanced dementia do not receive optimal end-of-life care.³

Clinical Care in the Aging Century – Announcing “Care of the Aging Patient: From Evidence to Action”

C. Seth Landefeld, MD; Margaret A. Winker, MD; Bruce Chernof, MD

JAMA 2009 302(24):2703-2704 (December 23/30, 2009) (Reprinted)

Aging will shape societies, economies, the lives of patients, and the practice of medicine. In the “aging century,” life in the 10th decade will be a new frontier for medicine and society—a part of life about which medicine now knows relatively little. The long-delayed linkage of medical care to social care may promote independence and wellbeing for those on the aging frontier.³